OBJECTIVE
To evaluate the concentrations of CC-chemokines and stable metabolites of nitric oxide (NO) and endothelin-1 (ET-1) in patients with atherothrombotic (AT) and cardioembolic (CE) subtypes of ischemic stroke (IS) in the acute period.
MATERIAL AND METHODS
Sixty patients diagnosed with IS in the carotid basin were examined. Group 1 included 30 patients with AT, group 2 — 30 patients with CE subtype of IS. The control group consisted of 20 age-matched patients without a history of stroke. All patients were assessed on admission for functional status using the Barthel Index (BI), the Modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Neuroimaging parameters were assessed using CT/MRI data. Laboratory diagnostics included assessment of serum concentrations of interleukin (IL)-1β, IL-6, IL-16, interferon gamma (IFN-γ), CC-chemokines (CCL2, CCL-7, CCL8, CCL13, CCL15, CCL23) and stable metabolites of NO and ET-1.
RESULTS
All patients with IS had moderate stroke severity scores according to NIHSS, BI and mRS. Analysis of the indices of the main clinical scales revealed
higher NIHSS scores, the prevalence of body mass index (BMI), the size of IS foci and the presence of multifocal lesions in patients of group 2. Compared with the control group, a significant increase of IFN- γ and IL-16 was noted in patients of both groups; ET-1, CCL2 and CCL15 were elevated in group 1; IL-1β, IL-6, CCL8 and CCL23 — in group 2. A comparative analysis between groups revealed higher concentrations of ET-1, CCL2 and CCL15 in group 1 and the increase of IL-1β, IL-6, IL-16 and CCL13 in group 2.
CONCLUSION
The results allow considering cytokines CCL23, IL-6, IL-16, IL-1β and IFN-γ as indicators of IS severity; CCL2, CCL15 and ET-1 as important regulators of atherogenesis and indicators of the AT subtype of IS; IL-1β, IL-6 and CCL13 as markers of complications of atrial fibrillation. The findings indicate the necessity of multicentre studies with a large sample size to determine the potential value of CCR1/CCR2 chemokines and stable metabolites as biomarkers of course of different IS subtypes.